Digestion in Older People

Why persistent loss of appetite and suddenly weight loss must be taken seriously?

Intermittent symptoms from the digestive system are common throughout life, and are generally not of great significance. The magnitude of the inconvenience is not matched by serious consequences. However, during the aging process abnormalities of the gut become increasingly frequent, and symptoms may therefore change and increase in importance. Perversely, some potentially dangerous abdominal conditions sometimes become asymptomatic in older people. In additional some bowel upsets are due to changes in other distant systems. Diagnostic problems in digestive upsets, therefore, become increasingly complex with aging.

Persistent loss of appetite and sudden weight loss must always be taken seriously. Usually they are non-specific markers of an underlying illness. Chronic ill-health due to longstanding heart failure, recurrent bronchitis, or severe arthritis and many other conditions may be responsible. An occult growth or infection in any system can lead to weight loss. An upset in the endocrine glands, as for example in diabetes, or an over-active thyroid gland, can lead to dramatic weight reduction, but these are not usually associated with a poor appetite. The opposite may even be the case.

Psychological disturbances—especially depression—can also significantly upset a patient’s desire for food and the resultant reduced intake can lead to weight loss. Many medications can also impair appetite and cause nausea and vomiting.

Because weight loss and appetite changes are such ubiquitous complaints, it is the associated symptoms that act as clues to the site of the precipitating cause. Nausea, vomiting, abdominal pain, and changes in bowel habit are all concurrent problems that may indicate a potential gastrointestinal abnormality.